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Advance Health Care Directive
Anticipado de Atención de Salud de California

Everyone should fill out an Advanced Healthcare Directive.  It is a simple form you can fill out that tells your doctor and loved ones exactly what to do at the end of your life, or if you cannot speak for yourself. 
The Imperial County Long Term Care Ombudsman Program has a free, simple form that you can use created by The Regents of the University of California in both English and Spanish for your use.  Just print it out, complete the form, and sign it. Then give copies to your doctors, family, and/or friends. This will make sure that your values and choices are met.
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advance_health_care_directive_-_english.pdf
File Size: 1743 kb
File Type: pdf
Download File

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advance_health_care_directive_-_spanish.pdf
File Size: 11881 kb
File Type: pdf
Download File

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ahcd_checklist.pdf
File Size: 688 kb
File Type: pdf
Download File

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If you cannot print the form, we can send you a free copy.  Just call the the Long Term Care Ombudsman Program at 
(442) 265-7032
Imperial County Public Administrator Area Agency on Aging 778  W. State Street, El Centro, CA  92243 (442) 265-7000
  • Home
  • Public Administrator
    • Estate Sales
    • Indigent Burial
    • Public Guardian
  • Area Agency on Aging
    • Area Plan Fourth Year
    • Public Service Announcements
    • California Senior Legislature
    • Advisory Council >
      • Vacancy
      • Agendas >
        • Archived Agendas & Minutes
    • Service Providers >
      • Senior Meals & Food Distribution >
        • Congregate Meals
        • Home Delivered Meals
      • HICAP (Insurance Counseling)
      • Information & Assistance >
        • Virtual Community Education
      • In-Home Respite Care
      • Legal Assistance >
        • Advance Health Care Directive
        • Living Trust
        • Power of Attorneys
        • Transfer of Deed
        • Wills
      • Long-Term Care Ombudsman >
        • Facility Listing
        • Advance Directive
        • Residents Rights
        • Elder Abuse >
          • MEDICAL - SCAMS
        • Volunteer Opportunity
      • Senior Health Care
      • ADRC
      • Dementia Division
    • Resources-Data-Statistics
  • Title 22 & AB 2800
  • Contact Us
    • Feedback
    • Grievances & Complaints
  • Voting in Imperial County
  • C4A - California Association AAA